scholarly journals Accuracy of self-reported HIV testing history and awareness of HIV-positive status among people living with HIV in four Sub-Saharan African countries

2020 ◽  
Author(s):  
Yiqing Xia ◽  
Rachael M. Milwid ◽  
Arnaud Godin ◽  
Mare-Claude Boily ◽  
Leigh F. Johnson ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Latent Class ◽  
Latent Class Models ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Hiv Status ◽  
African Countries ◽  
Sub Saharan ◽  
Living With Hiv

Background: In many countries in Sub-Saharan Africa, self-reported HIV testing history and awareness of HIV-positive status from household surveys are used to estimate the percentage of people living with HIV (PLHIV) who know their HIV status. Despite widespread use, there is limited empirical information on the sensitivity of those self-reports, which can be affected by non-disclosure. Methods: Bayesian latent class models were used to estimate the sensitivity of self-reported HIV testing history and awareness of HIV-positive status in four Population-based HIV Impact Assessment surveys in Eswatini, Malawi, Tanzania, and Zambia. Antiretroviral (ARV) metabolites biomarkers were used to identify persons on treatment who did not accurately report their status. For those without ARV biomarkers, the pooled estimate of non-disclosure among untreated persons was 1.48 higher than those on treatment. Results: Among PLHIV, the sensitivity of self-reported HIV testing history ranged 96% to 99% across surveys. Sensitivity of self-reported awareness of HIV status varied from 91% to 97%. Non-disclosure was generally higher among men and those aged 15-24 years. Adjustments for imperfect sensitivity did not substantially influence estimates of of PLHIV ever tested (difference <4%) but the proportion of PLHIV aware of their HIV-positive status was higher than the unadjusted proportion (difference <8%). Conclusions: Self-reported HIV testing histories in four Eastern and Southern African countries are generally robust although adjustment for non-disclosure increases estimated awareness of status. These findings can contribute to further refinements in methods for monitoring progress along the HIV testing and treatment cascade.

scholarly journals Accuracy of self-reported HIV testing history and awareness of HIV-positive status among people living with HIV in four Sub-Saharan African countries

AIDS ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Yiqing Xia ◽  
Rachael M. Milwid ◽  
Arnaud Godin ◽  
Marie-Claude Boily ◽  
Leigh F. Johnson ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
African Countries ◽  
Sub Saharan ◽  
Living With Hiv

HIV/AIDS

2020 ◽  
pp. 901-933
Author(s):  
Sarah Fidler ◽  
Timothy E.A. Peto ◽  
Philip Goulder ◽  
Christopher P. Conlon
Keyword(s):  
Large Scale ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
African Countries ◽  
Global Pandemic ◽  
The People ◽  
Reduce Life Expectancy ◽  
Sub Saharan ◽  
Living With Hiv ◽  
The Impact

Since its discovery in 1983, the human immunodeficiency virus (HIV) has been associated with a global pandemic that has affected more than 78 million people and caused more than 39 million deaths. Globally, 36.9 million (34.3–41.4 million) people were living with HIV at the end of 2013. An estimated 0.8% of adults aged 15–49 years worldwide are living with HIV, although the burden of the epidemic continues to vary considerably between countries and regions. Sub-Saharan Africa remains most severely affected, with nearly 1 in every 20 adults living with HIV and accounting for nearly 71% of the people living with HIV worldwide. The impact of HIV in some African countries has been sufficient to reverse population growth and reduce life expectancy into the mid-30s, although HIV incidence has declined in some of these high-prevalence countries. However, there are large-scale HIV epidemics elsewhere (e.g. India, the Russian Federation, and Eastern Europe).

scholarly journals Mapping evidence on adolescents’ HIV-positive status disclosure in sub-Saharan Africa: a protocol for a scoping review

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Patience Adzordor ◽  
Clement Avoka ◽  
Vitalis Bawontuo ◽  
Silas Agbesi ◽  
Desmond Kuupiel
Keyword(s):  
Hiv Infection ◽  
Scoping Review ◽  
Keyword Search ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Status Disclosure ◽  
Hiv Aids

Abstract Background Sub-Saharan Africa (SSA) homes most of the people living with HIV/AIDS in the world. Adolescents/young people are a vulnerable population and at high risk of HIV infection. Identifying and bridging the research gaps on the disclosure of HIV-positive status among adolescents, particularly to their sexual partners, is essential to inform appropriate policy planning and implementation towards preventing HIV transmission. This study will aim to explore literature and describe the evidence on HIV-positive status disclosure among adolescents in SSA. Methods The framework provided by Arksey and O’Malley’s framework and improved by Levac and colleagues will be used to conduct a scoping review. A keyword search for relevant literature presenting evidence on HIV-positive status disclosure among adolescents in SSA will be conducted in CINAHL, PubMed, Science Direct, Google Scholar, and SCOPUS. Date limitations will be removed, but Boolean terms “AND” and “OR” as well as Medical Subject Headings terms will be included where possible and syntax modified to suit the database during the search. Additional relevant articles will be sought from the reference lists of all included studies using a snowballing method. Two reviewers will independently screen the articles at the abstract and full-text screening phases in order to reduce bias and improve the reliability of this study’s findings. A tabular form will be developed using Microsoft Word and piloted for data extraction. Thematic content analysis will be conducted, and a narrative summary of all relevant outcomes reported. Quality appraisal of the included studies for this proposed study will be performed utilizing the recent mixed methods appraisal tool. Discussion The evidence produced by this review may help inform policy and strategies to reduce the incidence of HIV infection among adolescents and improve social support for adolescents living with HIV/AIDS in SSA. It may also reveal literature gaps to guide future researches to further inform HIV policies for adolescents in SSA. Platforms such as peer review journals, policy briefs, and conferences will be used to disseminate this study’s findings.

scholarly journals Trends in knowledge of HIV status and efficiency of HIV testing services in Sub-Saharan Africa (2000-2020): a modelling study of survey and HIV testing program data

2020 ◽  
Author(s):  
Katia Giguère ◽  
Jeffrey W. Eaton ◽  
Kimberly Marsh ◽  
Leigh F. Johnson ◽  
Cheryl C. Johnson ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Median Time ◽  
Credible Interval ◽  
Population Based ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Hiv Testing Services ◽  
Sub Saharan ◽  
First Time

AbstractBackgroundKnowledge of HIV status (KOS) among people living with HIV (PLHIV) is essential for an effective national HIV response. This study estimates progress and gaps in reaching the UNAIDS 2020 target of 90% KOS, and the efficiency of HIV testing services (HTS) in sub-Saharan Africa (SSA), where two thirds of all PLHIV live.MethodsWe used data from 183 population-based surveys (N=2.7 million participants) and national HTS programs (N=315 country-years) from 40 countries as inputs into a mathematical model to examine trends in KOS among PLHIV, median time from HIV infection to diagnosis, HIV testing positivity, and proportion of new diagnoses among all positive tests, adjusting for retesting.FindingsAcross SSA, KOS steadily increased from 6% (95% credible interval [95%CrI]: 5% to 7%) in 2000 to 84% (95%CrI: 82% to 86%) in 2020. Twelve countries and one region, Southern Africa, reached the 90% target. In 2020, KOS was lower among men (79%) than women (87%) across SSA. PLHIV aged 15-24 years were the least likely to know their status (65%), but the largest gap in terms of absolute numbers was among men aged 35-49 years, with over 700,000 left undiagnosed. As KOS increased from 2000 to 2020, the median time to diagnosis decreased from 10 to 3 years, HIV testing positivity declined from 9% to 3%, and the proportion of first-time diagnoses among all positive tests dropped from 89% to 42%.InterpretationOn the path towards the next UNAIDS target of 95% diagnostic coverage by 2030, and in a context of declining positivity and yield of first-time diagnoses, we need to focus on addressing disparities in KOS. Increasing KOS and treatment coverage among older men could be critical to reduce HIV incidence among women in SSA, and by extension, reducing mother-to-child transmission.

scholarly journals National HIV testing and diagnosis coverage in sub-Saharan Africa: a new modeling tool for estimating the “first 90” from program and survey data

2019 ◽  
Author(s):  
M Maheu-Giroux ◽  
K Marsh ◽  
C Doyle ◽  
A Godin ◽  
C Lanièce Delaunay ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Critical Role ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Hiv Diagnosis ◽  
Hiv Knowledge ◽  
Out Of Sample ◽  
Living With Hiv ◽  
Program Data

AbstractObjectiveHIV testing services (HTS) are a crucial component of national HIV responses. Learning one’s HIV diagnosis is the entry point to accessing life-saving antiretroviral treatment and care. Recognizing the critical role of HTS, theJoint United Nations Programme on HIV/AIDS(UNAIDS) launched the 90-90-90 targets stipulating that by 2020, 90% of people living with HIV know their status, 90% of those who know their status receive antiretroviral therapy, and 90% of those on treatment have a suppressed viral load. Countries will need to regularly monitor progress on these three indicators. Estimating the proportion of people living with HIV who know their status (i.e., the “first 90”), however, is difficult.MethodsWe developed a mathematical model (henceforth referred to as “F90”) that formally synthesizes population-based survey and HTS program data to estimate HIV status awareness over time. The proposed model uses country-specific HIV epidemic parameters from the standard UNAIDS Spectrum model to produce outputs that are consistent with other national HIV estimates. The F90 model provides estimates of HIV testing history, diagnosis rates, and knowledge of HIV status by age and sex. We validate the F90 model using both in-sample comparisons and out-of-sample predictions using data from three countries: Côte d’Ivoire, Malawi, and Mozambique.ResultsIn-sample comparisons suggest that the F90 model can accurately reproduce longitudinal sex-specific trends in HIV testing. Out-of-sample predictions of the fraction of PLHIV ever tested over a 4-to-6-year time horizon are also in good agreement with empirical survey estimates. Importantly, out-of-sample predictions of HIV knowledge are consistent (i.e., within 4% points) with those of the fully calibrated model in the three countries, when HTS program data are included. The F90 model’s predictions of knowledge of status are higher than available self-reported HIV awareness estimates, however, suggesting –in line with previous studies– that these self-reports are affected by non-disclosure of HIV status awareness.ConclusionKnowledge of HIV status is a key indicator to monitor progress, identify bottlenecks, and target HIV responses. The F90 model can help countries track progress towards their “first 90” by leveraging surveys of HIV testing behaviors and annual HTS program data.

scholarly journals Epidemiological rather than macro-economic factors correlate with socioeconomic inequalities in HIV testing in 16 sub-Saharan African countries

2021 ◽  
Author(s):  
Pearl Anne Ante-Testard ◽  
Laura Temime ◽  
Kevin Jean
Keyword(s):  
Hiv Testing ◽  
Contextual Factors ◽  
Socioeconomic Inequalities ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Economic Factors ◽  
African Countries ◽  
Hiv Epidemic ◽  
Testing Uptake ◽  
Sub Saharan

In order to reach the first 95 (i.e., 95% of people living with HIV having knowledge of their status) of the 2030 UNAIDS 95-95-95 targets, it is crucial to better understand the contextual or structural factors driving socioeconomic inequalities in HIV testing uptake. It is still unclear whether they are mostly influenced by epidemiological or by macro-economic factors. Here, to shed light on this issue, we measured and decomposed socioeconomic inequalities in HIV testing in sub-Saharan Africa in relation to contextual factors using a novel method, the Recentered Influence Function decomposition method. Indeed, we found that HIV testing uptake was more concentrated among the rich in 12 of 16 sub-Saharan African countries based on population-based surveys. The level of the HIV epidemic seems to drive the level of response of HIV testing programs, rather than the per capita Gross Domestic Product of a country (i.e., national indicator of economic development). Our results suggest that when responding to the HIV epidemic, there is a need to monitor and assess inequalities in addition to monitoring HIV incidence and prevalence. Keywords: HIV, HIV testing, socioeconomic inequalities, contextual factors, sub-Saharan Africa, decomposing inequalities

scholarly journals The urgent need for the use of pre-exposure prophylaxis (PrEP) in the prevention of HIV/AIDS in Sub-Saharan Africa

2019 ◽  
Vol 5 (2) ◽  
pp. 197-204
Author(s):  
Israel Oluwasegun Ayenigbara
Keyword(s):  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
African Countries ◽  
Aids Epidemic ◽  
The World ◽  
Sub Saharan ◽  
Exposure Prophylaxis ◽  
Living With Hiv ◽  
Prevention Of Hiv ◽  
Hiv Aids

Human immunodeficiency virus (HIV) is an infection that came into existence decades back; it spread across the African countries in the late 1970s, and is currently endemic across the world. HIV is a major public health problem all over the world, as it has claimed more than 35million lives. There were around 36.9 million individuals living with HIV at the end of 2017, and Sub-Saharan Africa remains the most affected by HIV infection with 1 in 25 adults (4.1%) living with the virus, accounting for 70% of the people living with HIV worldwide. Unfortunately, Sub-Saharan Africa continues to be the continent with the highest cases of infections and deaths from HIV/AIDS even after the implementation of various HIV/AIDS prevention methods. Fortunately, pre-exposure prophylaxis (PrEP) offers the world a novel way of curtailing the HIV/AIDS epidemic, as PrEP is highly effective for preventing HIV if it is used as prescribed. This paper discusses the urgent need for the use of PrEP in the prevention of HIV/AIDS in Sub-Saharan Africa. It is a review paper in which the meaning of PrEP was discussed, people who need PrEP were identified, the rationale for the use of PrEP for the prevention of HIV/AIDS in Sub-Saharan Africa were highlighted, and probable obstacles to the successful implementation of PrEP for the prevention of HIV/AIDS in Sub-Saharan Africa were also identified. It was concluded that to achieve the 90-90-90 goals set by UNAIDS to help end the AIDS epidemic in the world, PrEP offers a new and novel way for HIV prevention, and its implementation across all African countries is urgently needed for the prevention of HIV/AIDS in Sub-Saharan Africa.

scholarly journals A Scoping Review on Nutrition Challenges Among People Living With HIV/AIDS in Sub-Saharan Africa

2019 ◽  
Vol 11 (12) ◽  
pp. 109 ◽  
Author(s):  
Tafadzwa Dzinamarira ◽  
Gashema Pierre ◽  
Itai Chitungo ◽  
Michael Habtu ◽  
Rosemary Okova
Keyword(s):  
Food Insecurity ◽  
Severe Acute Malnutrition ◽  
Sub Saharan Africa ◽  
Acute Malnutrition ◽  
Future Research ◽  
People Living With Hiv ◽  
African Countries ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Hiv Aids

The connection between under-nutrition and HIV is bidirectional. It affects the quality of life, as well as the survival of affected people. While this is the case, there are various nutritional challenges, which are faced by people living with HIV/AIDS (PLWH), and which hamper the fight against the scourge. This study therefore sought to map literature on the nutritional challenges among PLWH in sub-Saharan Africa and guide future research in nutritional management to improve health outcomes for PLWH. A systematic search was done from the following sources: PubMed, the Cochrane Database of Systematic Reviews, EBSCOhost (CINAHL and Academic Search Complete), Web of Science, and Google Scholar. In addition, information was obtained both from unpublished studies, which included book chapters, reference lists, theses and conference papers. Eleven (11) studies met the inclusion criteria, and were used for data extraction. The studies were based in different countries, which form part of the Sub Saharan Africa. One of the studies was carried out in Senegal, two studies were carried out in various West African countries, one study was carried out in Burkina Faso; one study was carried out in Ethiopia and one of the studies was carried out in different countries forming part of the Sub Saharan Africa. Two of the studies were carried out in Zambia, one in Zimbabwe, one in Cameroon, and one in Ghana. Most of the studies established the main nutrition challenge facing PLWH to be food insecurity. Based on the findings of the study, it can be concluded that some of the main nutrition challenges include food insecurity, lack of nutritional support among PLWH, late detection of HIV, huge cost of treating severe acute malnutrition, and lack of feeding supplementations.

scholarly journals Neurological Manifestations among Patients with HIV – Active Tuberculosis co Infection

2020 ◽  
pp. 25-30
Author(s):  
Mohamed A. Taha ◽  
Amira Sidig ◽  
Osman. B. M. O. Arbb ◽  
Abbashar M. Hussein ◽  
Musaab M. Alfaki ◽  
...  
Keyword(s):  
Latent Tuberculosis ◽  
Active Tuberculosis ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
People Living With Hiv ◽  
Neurological Manifestations ◽  
Cns Involvement ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Great Burden

At least one-third of the 35.3 million people living with HIV worldwide are infected with latent tuberculosis. Tuberculosis is the most common presenting illness among people living with HIV, including those who are taking antiretroviral treatment. There were an estimated 1.1 million HIV positive new TB cases globally in 2012. Around 75% of these people live in sub-Saharan Africa. Despite its great burden, neurological manifestations have not been described yet in patients with HIV-active tuberculosis, although tuberculosis and HIV have synergistic influence on immunity system which may contribute to change in prevalence or severity of CNS involvement in patients with HIV-active TB co infection. Objectives: To study neurological manifestations in patients with HIV-active tuberculosis.

scholarly journals Sex, HIV Status, and Measures of Cardiac Stress and Fibrosis in Uganda

2021 ◽  
Author(s):  
Jasmine Kipke ◽  
Seunghee Margevicius ◽  
Cissy Kityo ◽  
Grace Mirembe ◽  
Jonathan Buggey ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cystatin C ◽  
Sub Saharan Africa ◽  
Cardiac Biomarkers ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Growth Differentiation Factor 15 ◽  
Differentiation Factor ◽  
Sub Saharan ◽  
Living With Hiv

Background Biomarkers of myocardial stress and fibrosis are elevated in people living with HIV and are associated with cardiac dysfunction. It is unknown whether sex influences these markers of heart failure risk in sub‐Saharan Africa, where HIV burden is high and where the vast majority of women with HIV live. Methods and Results Echocardiograms and 6 plasma biomarkers (suppression of tumorigenicity‐2, growth differentiation factor 15, galectin 3, soluble fms‐like tyrosine kinase‐1, NT‐proBNP [N‐terminal pro‐B‐type natriuretic peptide], and cystatin C) were obtained from 100 people living with HIV on antiretroviral therapy and 100 HIV‐negative controls in Uganda. All participants were ≥45 years old with ≥1 major cardiovascular risk factor. Multivariable linear and logistic regression models were used to assess associations between biomarkers, echocardiographic variables, HIV status, and sex, and to assess whether sex modified these associations. Overall, mean age was 56 years and 62% were women. Suppression of tumorigenicity‐2 was higher in men versus women ( P <0.001), and growth differentiation factor 15 was higher in people living with HIV versus controls ( P <0.001). Sex modified the HIV effect on cystatin C and NT‐proBNP (both P for interaction <0.025). Women had more diastolic dysfunction than men ( P= 0.02), but there was no evidence of sex‐modifying HIV effects on cardiac structure and function. Cardiac biomarkers were more strongly associated with left ventricular mass index in men compared with women. Conclusions There are prominent differences in biomarkers of cardiac fibrosis and stress by sex and HIV status in Uganda. The predictive value of cardiac biomarkers for heart failure in people living with HIV in sub‐Saharan Africa should be examined, and novel risk markers for women should be further explored.

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